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Labor Induction

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2. Practice Advisory: Clinical guidance for integration of the findings of The ARRIVE Trial: Labor Induction versus Expectant Management in Low-Risk Nulliparous Women

Practice Advisory: Clinical guidance for integration of the findings of The ARRIVE Trial: Labor Induction versus Expectant Management in Low-Risk Nulliparous Women Practice Advisory: Clinical guidance for integration of the findings of The ARRIVE Trial: Labor Induction versus Expectant Management in Low-Risk Nulliparous Women - ACOG Menu ▼ Practice Advisory: Clinical guidance for integration of the findings of The ARRIVE Trial: Labor Induction versus Expectant Management in Low-Risk Nulliparous (...) Women Page Navigation ▼ Share: Practice Advisory: Clinical guidance for integration of the findings of The ARRIVE Trial: Labor Induction versus Expectant Management in Low-Risk Nulliparous Women This Practice Advisory has been endorsed by the Society for Maternal-Fetal Medicine. A randomized controlled trial comparing elective induction of labor at 39 weeks gestation with expectant management among low-risk nulliparous women was published in the on August 8, 2018 (1). The study was a large unmasked

2018 American College of Obstetricians and Gynecologists

3. Factors that affect ultrasound-determined labor progress in women undergoing induction of labor. (PubMed)

Factors that affect ultrasound-determined labor progress in women undergoing induction of labor. The traditional approach to assessing labor progress is by digital vaginal examination, however, it is subjective and imprecise. Recent studies have investigated the role of transperineal ultrasonographic assessment of fetal head descent by measuring angle of progression and head-perineum distance.The objective of this study was to evaluate factors that affected labor progress, defined (...) by the transperineal ultrasonographic parameters, in women achieving vaginal delivery.This was a prospective longitudinal study performed in 315 Chinese women with singleton pregnancy undergoing labor induction at term between December 2016 and December 2017. Paired assessment of cervical dilatation and fetal head station by vaginal examination and transperineal ultrasonographic assessment of fetal head descent (para-sagittal angle of progression and head-perineum distance) were made serially following

2019 American Journal of Obstetrics and Gynecology

4. Increased labor induction and women presenting with decreased or altered fetal movements - a population-based survey. (PubMed)

Increased labor induction and women presenting with decreased or altered fetal movements - a population-based survey. Women's awareness of fetal movements is important as perception of decreased fetal movements can be a sign of a compromised fetus. We aimed to study rate of labor induction in relation to number of times women seek care due to decreased or altered fetal movements during their pregnancy compared to women not seeking such care. Further, we investigated the indication (...) of induction.A prospective population-based cohort study including all obstetric clinics in Stockholm, Sweden. Questionnaires were distributed to women who sought care due to decreased or altered fetal movements ≥ 28 week's gestation in 2014, women for whom an examination did not indicate a compromised fetus that required induction of labor or cesarean section when they sought care. Women who gave birth at ≥ 28 weeks' gestation in 2014 in Stockholm comprises the reference group.Labor was induced more often

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2019 PLoS ONE

5. Comparison of outcomes between induction of labor and spontaneous labor for term breech - A systemic review and meta analysis.

Comparison of outcomes between induction of labor and spontaneous labor for term breech - A systemic review and meta analysis. Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity.Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing (...) studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included. Perinatal morbidity was calculated by RevMan 5 and presented by pooled odds ratio with 95% confidence intervals.Cesarean section rate and neonatal intensive care unit admission were increased in induction of breech labor as compared with spontaneous breech labor. No significant difference in umbilical cord blood base excess ≤ -12 mmol/L, Apgar 5 min < 7, Apgar 5 min < 4, umbilical cord blood PH 

2018 European journal of obstetrics, gynecology, and reproductive biology

6. Nitric Oxide Donor Isosorbide Mono Nitrate for Induction of Labor With Pre-labor Rupture of Membranes

Nitric Oxide Donor Isosorbide Mono Nitrate for Induction of Labor With Pre-labor Rupture of Membranes Nitric Oxide Donor Isosorbide Mono Nitrate for Induction of Labor With Pre-labor Rupture of Membranes - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Nitric Oxide Donor Isosorbide Mono Nitrate for Induction of Labor With Pre-labor Rupture of Membranes The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03665779 Recruitment

2018 Clinical Trials

7. Contraction of the levator ani muscle during Valsalva maneuver (co-activation) is associated with a longer active second stage of labor in nulliparous women undergoing induction of labor. (PubMed)

Contraction of the levator ani muscle during Valsalva maneuver (co-activation) is associated with a longer active second stage of labor in nulliparous women undergoing induction of labor. The Valsalva maneuver is normally accompanied by relaxation of the levator ani muscle, which stretches around the presenting part, but in some women the maneuver is accompanied by levator ani muscle contraction, which is referred to as levator ani muscle coactivation. The effect of such coactivation on labor (...) outcome in women undergoing induction of labor has not been previously assessed.The aim of the study was to assess the effect of levator ani muscle coactivation on labor outcome, in particular on the duration of the second and active second stage of labor, in nulliparous women undergoing induction of labor.Transperineal ultrasound was used to measure the anteroposterior diameter of the levator hiatus, both at rest and at maximum Valsalva maneuver, in a group of nulliparous women undergoing induction

2018 American Journal of Obstetrics and Gynecology

8. A validated calculator to estimate risk of cesarean after an induction of labor with an unfavorable cervix

A validated calculator to estimate risk of cesarean after an induction of labor with an unfavorable cervix Induction of labor occurs in >20% of pregnancies, which equates to approximately 1 million women undergoing an induction in the United States annually. Regardless of how common inductions are, our ability to predict induction success is limited. Although multiple risk factors for a failed induction have been identified, risk factors alone are not enough to quantify an actual risk (...) cohort of women from the same institution who underwent an induction (n = 364) during the trial period. An external validation was performed utilizing a publicly available database (Consortium for Safe Labor) that includes information for >200,000 deliveries from 19 hospitals across the United States from 2002 through 2008. After applying the same inclusion and exclusion criteria utilized in the derivation cohort, a total of 8466 women remained for analysis. The discriminative power of each model

2018 EvidenceUpdates

9. Induction of labor using one dose vs multiple doses of misoprostol: a randomized controlled trial

Induction of labor using one dose vs multiple doses of misoprostol: a randomized controlled trial Misoprostol is a common agent that is used to ripen the cervix and induce labor, yet there is no clear evidence of the optimal number of doses needed to achieve a higher rate of vaginal delivery.Our primary objective was to compare the rate of vaginal delivery within 24 hours between a 1-dose and a multiple-dose regimen of misoprostol for the induction of labor.A randomized controlled trial (...) was conducted from March 2016 to March 2017 that compared a single dose to up to 4 doses of misoprostol. Randomization was stratified by parity. Women with a singleton pregnancy ≥37 weeks gestation with intact membranes who had been admitted for labor induction with a Bishop score ≤6 were included. Our primary outcome was the rate of vaginal delivery within 24 hours. Secondary outcomes included time to vaginal delivery, cesarean delivery rate, and maternal and neonatal morbidity. Based on a power of 80

2018 EvidenceUpdates

10. Outpatient Foley Catheter for Induction of Labor in Parous Women: A Randomized Controlled Trial

Outpatient Foley Catheter for Induction of Labor in Parous Women: A Randomized Controlled Trial To assess whether outpatient cervical ripening with a transcervical Foley catheter in parous women undergoing elective induction of labor shortens the total duration of time from admission to the labor ward until delivery.We performed an open-label randomized controlled trial at a single academic center in parous women at 39 weeks of gestation or greater with a cervix 3 cm or less dilated, or, if 2-3 (...) transcervical catheter placement and concomitant oxytocin infusion on the labor ward. Women in the outpatient group were instructed to return to the hospital the next day or sooner if labor occurred. Induction of labor was managed per institutional protocol, and once participants were admitted, oxytocin was initiated. The primary outcome was the duration of time from labor ward admission until delivery. Based on a prior study in our institution, a total of 128 women were needed for 80% power to detect a 12

2018 EvidenceUpdates

11. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. (PubMed)

Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. The perinatal and maternal consequences of induction of labor at 39 weeks among low-risk nulliparous women are uncertain.In this multicenter trial, we randomly assigned low-risk nulliparous women who were at 38 weeks 0 days to 38 weeks 6 days of gestation to labor induction at 39 weeks 0 days to 39 weeks 4 days or to expectant management. The primary outcome was a composite of perinatal death or severe neonatal (...) complications; the principal secondary outcome was cesarean delivery.A total of 3062 women were assigned to labor induction, and 3044 were assigned to expectant management. The primary outcome occurred in 4.3% of neonates in the induction group and in 5.4% in the expectant-management group (relative risk, 0.80; 95% confidence interval [CI], 0.64 to 1.00). The frequency of cesarean delivery was significantly lower in the induction group than in the expectant-management group (18.6% vs. 22.2%; relative risk

2018 NEJM

12. Stepwise Labor Induction Following Failure of Prostaglandin Vaginal Insert for Labor Induction

Stepwise Labor Induction Following Failure of Prostaglandin Vaginal Insert for Labor Induction Stepwise Labor Induction Following Failure of Prostaglandin Vaginal Insert for Labor Induction - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one (...) or more studies before adding more. Stepwise Labor Induction Following Failure of Prostaglandin Vaginal Insert for Labor Induction The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02684305 Recruitment Status : Unknown Verified March 2016 by Tel-Aviv Sourasky Medical Center. Recruitment status

2016 Clinical Trials

13. In labor or in limbo? The experiences of women undergoing induction of labor in hospital: Findings of a qualitative study. (PubMed)

In labor or in limbo? The experiences of women undergoing induction of labor in hospital: Findings of a qualitative study. Induction of labor currently accounts for around 25% of all births in high-resource countries, yet despite much research into medical aspects, little is known about how women experience this process. This study aimed to explore in depth the induction experience of primiparous women.A qualitative study was undertaken, using a sample of 21 first-time mothers from a maternity (...) unit in the south of England. Semi-structured interviews were conducted in women's homes between 3 and 6 weeks postnatally. Data were recorded, transcribed, and analyzed thematically.Women awaiting induction on the prenatal ward appeared to occupy a liminal state between pregnancy and labor. Differences were noted between women's and midwives' notions of what constituted "being in labor" and the ward lacked the flexibility to provide individualized care for women in early labor. Unexpected delays

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2017 Birth

14. Labor after cesarean delivery managed without induction or augmentation of labor. (PubMed)

Labor after cesarean delivery managed without induction or augmentation of labor. This study aimed to describe the perinatal outcomes of women opting for vaginal birth after cesarean delivery (VBAC) managed without induction or augmentation of labor.This was a retrospective cohort study of candidates for VBAC at a tertiary center in Japan from April 2003 to March 2012. Women with singleton gestations and one prior low-transverse cesarean delivery who intended VBAC at 36 weeks of gestation were (...) identified as candidates for VBAC and included in the study. Participants were managed without induction or augmentation of labor. Maternal characteristics and perinatal outcomes were obtained from medical records. Factors associated with successful VBAC were analyzed with a multivariable logistic regression model.Of 333 candidates for VBAC, 242 (72.7%) had vaginal birth, 49 (14.7%) had repeat cesarean delivery with spontaneous labor, and 42 (12.6%) had repeat cesarean delivery without spontaneous labor

2017 Birth

15. Identification of first stage labor arrest by electromyography in term nulliparous women after induction of labor. (PubMed)

Identification of first stage labor arrest by electromyography in term nulliparous women after induction of labor. Worldwide induction and cesarean delivery rates have increased rapidly, with consequences for subsequent pregnancies. The majority of intrapartum cesarean deliveries are performed for failure to progress, typically in nulliparous women at term. Current uterine registration techniques fail to identify inefficient contractions leading to first-stage labor arrest. An alternative (...) technique, uterine electromyography has been shown to identify inefficient contractions leading to first-stage arrest of labor in nulliparous women with spontaneous onset of labor at term. The objective of this study was to determine whether this finding can be reproduced in induction of labor.Uterine activity was measured in 141 nulliparous women with singleton term pregnancies and a fetus in cephalic position during induced labor. Electrical activity of the myometrium during contractions

2017 Acta Obstetricia et Gynecologica Scandinavica

16. Do Different Modes of Labor Induction Affect the Overall Success and Risk of Trial of Labor After Cesarean Section? (PubMed)

Do Different Modes of Labor Induction Affect the Overall Success and Risk of Trial of Labor After Cesarean Section? OBJECTIVE: To determine whether different modes of labor induction impact the success rate and perinatal morbidity in women undergoing trial of labor after cesarean (TOLAC). STUDY DESIGN: Retrospective review of the Consortium on Safe Labor electronic database from 2002�2008; women with a prior cesarean birth, desiring TOLAC, and requiring induction of labor were included (...) . Oxytocin and Foley bulb induction methods were compared to amniotomy alone. Prostaglandin use was also reviewed but, given the small numbers, was not the focus of this study. RESULTS: Univariate analysis showed significantly greater incidence of hemorrhage >1,000 mL (p=0.0030) and transfusion (p=0.0076) with Foley bulb use. All methods of induction for TOLAC decreased repeat cesarean sections (OR 0.34, 95% CI 0.23�0.52, p<0.01). CONCLUSION: Induction of labor does not alter the success rate for TOLAC

2017 Journal of Reproductive Medicine

17. Induction of Labor at 39 Weeks of Gestation vs. Expectant Management for Low-Risk Nulliparous Women: A Cost-Effectiveness Analysis. (PubMed)

Induction of Labor at 39 Weeks of Gestation vs. Expectant Management for Low-Risk Nulliparous Women: A Cost-Effectiveness Analysis. A large, recent multicenter trial found that induction of labor at 39 weeks for low-risk nulliparous women was not associated with an increased risk of cesarean delivery or adverse neonatal outcomes.We sought to examine the cost-effectiveness and outcomes associated with induction of labor at 39 weeks versus expectant management for low-risk nulliparous women (...) life years (QALY) for both the woman and neonate. Model inputs were derived from the literature, and a cost-effectiveness threshold was set at $100,000/QALY.In our theoretical cohort of 1.6 million women, induction of labor resulted in 54,498 fewer cesarean deliveries and 79,152 fewer cases of hypertensive disorders of pregnancy. Additionally, we found that induction of labor resulted in 795 fewer cases of stillbirth and 11 fewer neonatal deaths, despite 86 additional cases of brachial plexus

2019 American Journal of Obstetrics and Gynecology

18. Maternal and Newborn Outcomes with Elective Induction of Labor at Term. (PubMed)

Maternal and Newborn Outcomes with Elective Induction of Labor at Term. A growing body of evidence supports improved or not worsened birth outcomes with nonmedically indicated induction of labor at 39 weeks gestation compared with expectant management. This evidence includes 2 recent randomized control trials. However, concern has been raised as to whether these studies are applicable to a broader US pregnant population.Our goal was to compare outcomes for electively induced births at ≥39 weeks (...) interval, 0.15-0.38). Term elective induction was not associated with any statistically significant increase in adverse newborn infant outcomes. Elective induction of labor at 39 weeks gestation was associated with increased time from admission to delivery for both nulliparous (1.3 hours; 95% confidence interval, 0.2-2.3) and multiparous women (3.4 hours; 95% confidence interval, 3.2-3.6).Elective induction of labor at 39 weeks gestation is associated with a decrease in cesarean birth in nulliparous

2019 American Journal of Obstetrics and Gynecology

19. Vaginal Assessment and Expedited Amniotomy in Oral Misoprostol Labor Induction in Nulliparas: A Randomized Trial. (PubMed)

Vaginal Assessment and Expedited Amniotomy in Oral Misoprostol Labor Induction in Nulliparas: A Randomized Trial. Labor is induced in 20-30% of maternities, with an increasing trend of use. Labor induction with oral misoprostol is associated with reduced risk of cesarean deliveries and has a safety and effectiveness profile comparable to those of mechanical methods such as Foley catheter use. Labor induction in nulliparous women continues to be challenging, with the process often quite (...) protracted. The eventual cesarean delivery rate is high, particularly when the cervix is unfavorable and ripening is required. Vaginal examination can cause discomfort and emotional distress particularly to nulliparous women, and plausibly can affect patient satisfaction with the induction and birth process.The aim of this study was to evaluate regular (4-hourly prior to each oral misoprostol dose with amniotomy when feasible) compared with restricted (only if indicated) vaginal assessments during labor

2019 American Journal of Obstetrics and Gynecology

20. Effect of vaginal washing before intravaginal dinoprostone insertion for labor induction: A randomized clinical trial. (PubMed)

Effect of vaginal washing before intravaginal dinoprostone insertion for labor induction: A randomized clinical trial. Prostaglandins have a dual action of cervical ripening and induction of uterine contraction. This study was designed to compare the effectiveness of vaginal washing just before insertion of intravaginal dinoprostone.A randomized controlled trial was conducted at the Zeynep Kamil Women and Children's Health Training and Research Hospital. One hundred and ninety-one women (...) with singleton, term pregnancy who underwent labor induction were randomly assigned to two groups: Group 1 consisted of 95 pregnant women with vaginal washing before intravaginal dinoprostone (Propess system for slow release system of 10 mg of dinoprostone) insertion (study group), and 96 pregnant women constituted the control group who did not undergo vaginal washing before intravaginal dinoprostone insertion. A parallel randomized controlled trial was conducted with an allocation ratio of 1:1 to compare

2019 The journal of obstetrics and gynaecology research

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